Table 1 The definition of index established with the two round Delphi survey

Category	Sub-category	Component	Definition of Index
1. Patient-Doctor Relationship	1.1. Patient Welfare, Rights and Safety	1.1.1. Patient welfare	1. I can understand a patient’s best interests based on their medical interests, the patient’s preferences and other factors2. I can list the general responsibilities of a doctor for patients’ best interests.3. I can understand and manage the human, social and systematic elements that allow patients’ best interests to be secured.
		1.1.2. Patient rights	1. I can explain patients’ rights in general, including their right to receive the best medical care, their right not to be discriminated against and their right to self-determination.2. I can provide the basis of patients’ rights, including their right to receive the best medical care, their right not to be discriminated against and their right to self-determination.3. I can explain the principles and priorities related to a patient’s right to self-determination as applicable to different situations.
		1.1.3. Patient safety	1. I can explain doctors’ general responsibilities regarding patient safety.2. I can understand and manage the human and systematic factors that may precipitate a patient safety incident.3. I can explain the responsibility to open patient safety incidents, and the related report system and procedures.
	1.2. Communication and Asking for Consent	1.2.1. Communication	1. I can attentively listen to patients, respect their situations, and recognize and emphasize with their thoughts, emotions and value systems.2. I can collect necessary information from patients, understand patients’ situations, share information with patients and make agreements about future plans.3. In cases where a patient’s will is different from that of the caregiver or medical staff or where a patient does not want to let his or her situation be known to others, I can explain why the patient’s will should be considered preferentially.
		1.2.2. Asking for Consent	1. I can provide all relevant information and sufficient explanation to a patient and receive the patient’s consent accordingly.2. In cases where a patient’s decision-making capability is not complete (children, minors, dementia patients, mental patients and patients with compromised consciousness), I can assess whether someone meets the criteria necessary for the role of representative and the criteria for judging consent.5. In cases where a patient’s confidentiality is not protected, I can provide the patient with sufficient information about the exception and receive consent from the patient.6. I can record the details of the explanation provided by the doctor and the decisions made by patients (consent or refusal).
	1.3. Patient Privacy and Confidentiality	1.3.1. Privacy and Confidentiality	1. I can keep the confidentiality of the information obtained from patients, including mature minors, related to their specific disease and treatment during medical care as well as other personal information of the patients.
		1.3.2. Exceptions of Privacy and Confidentiality	1. In the exceptional cases where patient confidentiality is not protected, I can understand the relevant laws and information and provide them to patients.
	1.4. Truth telling	1.4.1. Giving Bad News	1. I can inform patients of bad news following the appropriate procedures, give proper explanations and converse empathetically to prepare future plans.2. I can inform families or caregivers about a patient’s cancer diagnosis or death following the appropriate procedures, give proper explanations about the severity of the patient’s disease and future plans, and converse empathetically.3. I can determine the cases where directly informing a patient of bad news may be deferred and handle those situations appropriately. (1. When the patient’s ability to make decisions has been severely damaged, such as cases of dementia patients, mentally impaired patients and children and 2. when the patient may suffer an intolerably severe medical effect by hearing the truth.)
		1.4.2. Publicizing and Apologizing for Medical Errors	1. I can communicate concerning the publicizing of medical errors according to the appropriate principles. (Honest communication is provided at an appropriate time. The errors are admitted, and regret or an apology is expressed. The expectations of the patients and their families are recognized while maintaining confidentiality.)
	1.5. Coping with Problematic Situations (Keeping Professional Boundaries with Patients)	1.5.1. Demands Against Medical Advices	1. I can appropriately cope with cases where a patient or a caregiver demands or refuses a test or treatment against a professional decision made by a medical worker.
		1.5.2. Professional Boundaries	1. I can explain the concept of professional boundaries. (Professional boundary refers to a boundary that should not be transgressed in order to maintain the integrity of a doctor- patient therapeutic relationship. This term also refers to the limits on behavior or attitude that a doctor and patient must adhere to in order to maintain the therapeutic relationship.)2. I can recognize a monetary or affectionate relationship that may threaten the patient- doctor relationship and cope with such situations appropriately.
2. Relationship Between Medical Care and Society	2.1. Understanding and Application of Medical Ethics Theory	2.1.1. Understanding of Ethical Theory and Ethical Reasoning	1. I can list and explain the four principles of medical ethics.3. I can reason ethically in various medical situations by applying the four principles of medical ethics and various other ethical theories and guidelines.
	2.2. Professionalism	2.2.1. Professionalism	1. I can list and explain the concept and components of professionalism.2. I can explain professional autonomy and social accountability.3. I can explain why ethical codes are necessary for medical professionals.
	2.3. Relationships with fellow medical workers	2.3.1. Communication	3. I can provide appropriate and sufficient information when transferring a patient or entrusting his or her medical service to a fellow doctor.
		2.3.2. Collaboration	1. I can maintain partnerships with fellow healthcare and medical workers, provide them professional opinions and cooperate with them (interprofessional collaboration).2. I can understand how medical staff provide medical services as a team and explain a doctors’ roles and responsibilities that enable a team to function effectively.
	2.4. Management of Conflicts of Interest	2.4.1. Conflicts of Interest	1. I can explain the concept of conflicts of interest.2. I can appropriately cope with the conflicts of interest resulting from the healthcare and medical service systems.3. I can appropriately handle the conflicts of interest occurring between doctors and companies.4. I can appropriately handle the conflicts of interests occurring in medical research.
		2.4.2. Prohibition of Unjust Enrichment	1. I can define unjust enrichment and explain the basis of the unjustness.2. I can list the types of unjust enrichment (medical service in the pursuit of unjust profits for a medical worker or his or her affiliated institution, demanding or receiving money or other valuables besides the medical service cost, joining in a medical service act in the pursuit of private profit by being employed by non-medical personnel, etc.)
	2.5. Coping with Medical Accidents and Disputes	2.5.1. Medical Accidents, Disputes and Lawsuits	2. I can understand the concepts related to medical accidents, disputes and lawsuits.
		2.5.2. Resolution of Medical Disputes	1. I can understand the process of medical dispute mediation law.2. I can understand and explain the legal process and the litigation.
	2.6. Distribution of Medical Resources	2.6.1. Distribution of Medical Resources	1. I can understand the principles and theories related to the distribution of medical resources.2. I can distinguish the medical conditions that should be considered from conditions that should not be considered in determining the priorities of medical service provision and medical resources distribution.
3. Individual field of Expertise	3.1. Reproduction- Related Ethics	3.1.2. Artificial Abortion	1. I can explain the (ethical and legal) details related to artificial abortion.3. I can explain the laws relevant to the allowable range of artificial abortion.4. I can understand the ethical issues concerning the life of a fetus and the self-determination of pregnant women.
	3.2. Ethics Related to Transplantation	3.2.2. Brain Death	1. I can understand the criteria and procedures for pronouncing brain death and adequately provide the relevant information to the caregivers of the patient.2. I can understand the ethical principles related to the selection of the beneficiaries of organ donation.
		3.2.3. Prohibition Against the Sale of Organs	1. I can understand the ethical and legal principles related to the prohibition against the sale of organs.
	3.3. Ethics Related to End-of-Life Medical Care	3.3.1. End-of-Life Medical Care	1. I can appropriately communicate bad news and express proper condolences.2. I can help a patient control his or her own body and personality as much as possible until death, and provide aid to establish an advance medical directive with the doctor.
		3.3.2. Medical Care for Life-Prolongation	1. I can understand the concepts of medical care for life-prolongation and the relevant ethical issues (the discontinuation and suspension of medical care for life-prolongation, DNR, death with dignity, euthanasia, physician-assisted suicide, persistent vegetative state, etc.).2. I can understand the laws related to the decisions concerning the provision of medical care for life-prolongation and carry out the procedures to decide whether to continue or discontinue medical care for life-prolongation.
		3.3.3. Hospice and Palliative Care	1. I can understand the concepts of hospice and palliative care and the scope of patients who are subject to hospice and palliative care, and adequately provide the relevant information to patients and their families (caregivers).
	3.4. Ethics Related to Public Health	3.4.1. Public Health	1. I can explain the roles and responsibilities in public health of individuals, the public, the state and medical professionals.
		3.4.2. Infectious Disease Control	1. I can explain the legal and ethical principles of infectious disease control.2. I can understand exceptional patient confidentiality cases and provide sufficient information to the patient in such cases.
	3.5. Ethics Related to Human Subject Research	3.5.1. Human Subject Research	2. I can explain the purposes and functions of institutional review boards.3. I can appropriately protect human subjects according to the guidelines for medical research.
		3.5.2. Informed Consent	2. I can explain matters that should be preferentially considered in order to protect vulnerable research subjects.
	3.6. Research Integrity	3.6.1. Research Integrity	2. I can explain the types of research misconduct that may violate research integrity.